Advice on Thyroid blood tests please?

[CarolineAnne]

hello everyone, could I get some input on my brother’s thyroid results please as I am attending his GP appointment with him. He has had three lots of thyroid testing since December 2023 and I think the first two results indicated Hypo and I believe that he should have been treated. However, a third test has revealed his TSH to be back in the higher part of the range so GP would not treat. His TPO were high. She has emailed Endocrinology for their advice and we have an appointment to discuss. At this point, I cannot gauge if they will treat him or not. I would be grateful for your advice as I am a bit rusty with all things thyroid now as I am doing well with my treatment. Myself and my other brother have Auto immune Hypothyroidism and it is looking like my youngest brother has too, from what I can understand. The tests were all ordered by his GP. Thank you.

December 2023

TSH 7.21 mIU/L ( 0 .55-4.78 )

FT4 13 pmol/L ( 11.50-22.70 )

January 2024

TSH 6.41 mIU/L ( 0.55-4.78 )

FT4 10.6 pmol/L ( 11.5-22.7 )

February 2024

TSH 3.7 mIU/L ( 0.55-4.78 )

TPO 652 ku/L ( < 61.00 )

HDL Cholesterol 1.2 mmol/L ( >1 )

Cholesterol/HDL Ratio 5.9 nmol/L ( <5 )

[SlowDragon Administrator]

Just testing TSH in last test is useless

For full Thyroid evaluation he needs TSH, FT4 and FT3 tested

Very important to test vitamin D, folate, ferritin and B12 at least once year minimum

His high thyroid antibodies confirms autoimmune thyroid disease

About 90% of primary hypothyroidism is autoimmune thyroid disease, usually diagnosed by high TPO and/or high TG thyroid antibodies

Autoimmune thyroid disease with goitre is Hashimoto’s

Autoimmune thyroid disease without goitre is Ord’s thyroiditis.

Both are autoimmune and generally called Hashimoto’s.

Low vitamin levels are extremely common when hypothyroid, especially with autoimmune thyroid disease

ESSENTIAL to get vitamin D, folate, ferritin and B12 tested NOW

In U.K. medics hardly ever refer to autoimmune thyroid disease as Hashimoto’s (or Ord’s thyroiditis)

Recommended that all thyroid blood tests early morning, ideally just before 9am, only drink water between waking and test

Did he do ALL tests early morning?

This gives highest TSH, lowest FT4 and most consistent results. (Patient to patient tip)

Private tests are available as NHS currently rarely tests Ft3 or all relevant vitamins

Testing options and includes money off codes for private testing

thyroiduk.org/testing/

Medichecks Thyroid plus BOTH TPO and TG antibodies and vitamins

medichecks.com/products/adv...

Blue Horizon Thyroid Premium Gold includes BOTH TPO and TG antibodies, cortisol and vitamins

bluehorizonbloodtests.co.uk...

Only do private testing early Monday or Tuesday morning.

Link about thyroid blood tests

thyroiduk.org/testing/thyro...

Link about Hashimoto’s

thyroiduk.org/hypothyroid-b...

Symptoms of hypothyroidism

thyroiduk.org/signs-and-sym...

Tips on how to do DIY finger prick test

support.medichecks.com/hc/e...

Medichecks and BH also offer private blood draw at clinic near you, or private nurse to your own home…..for an extra fee

Monitor My Health also now offer thyroid and vitamin testing, plus cholesterol and HBA1C for £65

(Doesn’t include thyroid antibodies)

monitormyhealth.org.uk/full...

10% off code here

thyroiduk.org/testing/priva...

[CarolineAnne in reply to SlowDragon]

Thank you. His Vit D, iron, ferritin, folate and Vitamin B12 results are all good as he has been supplementing. I agree with you about the last test. I will have to check with him about how early he did the blood test.

Do you think he should be offered a trial of Levothyroxine? What arguments can I use to ensure he gets treated if need be? Thank you

[SlowDragon Administrator in reply to CarolineAnne]

Get FULL thyroid and vitamin testing done privately yourselves at least every 6 months

TSH, Ft4 and Ft3 tested every 3 months

He needs coeliac blood test now, if not already on gluten free diet …as per NICE guidelines